Provider Demographics
NPI:1093467920
Name:ELEGANT SERVICES L.L.C
Entity Type:Organization
Organization Name:ELEGANT SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YASSIN
Authorized Official - Middle Name:KHADAR
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-442-2008
Mailing Address - Street 1:1405 SILVER LAKE RD NW STE 5
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-9309
Mailing Address - Country:US
Mailing Address - Phone:612-442-2008
Mailing Address - Fax:612-808-2045
Practice Address - Street 1:1405 SILVER LAKE RD NW STE 5
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-9309
Practice Address - Country:US
Practice Address - Phone:612-442-2008
Practice Address - Fax:612-808-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health